OBJECTIVE: The present review was conducted to assess the ability of the pulsed-xenon ultra-violet system (PX-UVL) to reduce healthcare-associated infections (HAI). METHODS: All types of studies available on PubMed, Embase, Scopus, and Web of Science databases assessing the risk of any HAI with the use of PX-UVL and published up to 25 February 2025 were included. Data on C. difficile infection (CDI), Methicillin-resistant Staphylococcus aureus (MRSA) infection, Vancomycin-resistant enterococci (VRE) infections, and Acinetobacter baumannii infections (ABI) was pooled. RESULTS: Fourteen studies were included. Most studies had a pre-post study design while two were controlled trials. Meta-analysis showed a statistically significant reduction in the risk of CDI with PX-UVL (RR: 0.76 95 % CI: 0.59, 0.97 I CONCLUSIONS: Current evidence from variable study designs suggests that PX-UVL may have limited efficacy in reducing HAI. Further high-quality randomized controlled trials will provide quality evidence.